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Looking for an approved ICE document/template? They can be found in the Approved ICE Documents folder - click here for a list of available documents for each ICE team: APPROVED ICE DOCUMENTS.

ICE documents can be altered for use by organizations/other regions as needed; however, the ICE logo/any ICE references should be removed if the document is not being used in its original format.

ICE is a voluntary 501(c)3 organization that includes participation by and advice from accrediting and regulatory agencies. The goal of ICE work products is to offer ICE participating organizations standardized tools and best practices toward optimizing efficiencies to implement health industry requirements. ICE heeds feedback from accrediting and regulatory agency partners regarding ICE work products; however, ICE does not obtain official regulatory approval for its work products. As such, ICE work products are not to be considered exempt from any approval process required by regulatory agencies.


 Click to open category Appeals and Grievances Improvement Team  
 Click to open category California Pharmacy Regulations Team (formerly SB 866 Team)  
 Click to open category California SB260  
 Click to open category Claims  
 Click to open category CMS Universe Templates  
 Click to open category Contracting & Compliance Team  
 Click to open category Credentialing Shared Audit Policy Team - Main / California  
 Click to open category Credentialing Shared Audit Policy Team - Main / Mid-Atlantic  
 Click to open category Credentialing Shared Audit Policy Team - Main / Northwest  
 Click to open category Cultural & Linguistic Services Team  
 Click to open category Cultural and Linguistics Provider Toolkit  
 Click to open category DMHC Access Regulations Team  
 Click to open category Health Risk Assessment (HRA) Team  
 Click to open category HIPAA  
 Click to open category Provider Directory Updates Team  
 Click to open category QI / UM Team - Main  
 Click to open category QI and UM Required Reports Team  
 Click to open category Risk Adjustment Data Acquisition & Reporting (RADAR) Team  
 Click to open category Site Visit Team (falls under Credentialing Shared Audit Policy Team - Main / California)  
 Click to open category UM Templates & Tools (Cal MediConnect) - Health Plan-Specific Templates  
 Click to open category UM Templates & Tools (Commercial UM LAP Templates for LAP Regulations Effective on and after 1/1/09)  
 Click to open category UM Templates & Tools (Commercial)  
 Click to close category UM Templates & Tools (Medi-Cal)  
     Click to open category Link to DHCS Documents
     Click to close category Click to Download All Documents in Subfolder Miscellaneous
       File   Upload
  Title     Size   Date
 ICE_UM_TAT_Medi-Cal_07.16 v2   53 KB   6/22/2017
 MediCal_ Deny_07012017   29 KB   6/9/2017
 MediCal_NOA Your Rights (Knox-Keene)_07012017   52 KB   6/9/2017
 MediCal_NOA Your Rights (non Knox-Keene)_07012017   41 KB   6/9/2017
 MediCal_NOA_Carve-Out_07012017   31 KB   6/9/2017
 MediCal_NOA_Delay_07012017   29 KB   6/9/2017
 MediCal_NOA_Language Assistance Taglines_07012017   59 KB   6/9/2017
 MediCal_NOA_Modify_07012017   31 KB   6/9/2017
 MediCal_NOA_Nondiscrimination Notice_07012017   48 KB   6/9/2017
 MediCal_NOA_Terminate_07012017   30 KB   6/9/2017
 Click to open category UM Templates & Tools (Medi-Cal) - Health Plan-Specific Templates  
 Click to open category UM Templates & Tools (Medicare Advantage Templates for Marketing Guidelines)  
 Click to open category UM Templates & Tools (Medicare Advantage)  

  Adobe Acrobat File
  Microsoft Word File
  Microsoft Excel File
  Microsoft PowerPoint File
  Microsoft Word XML File
  Microsoft Excel XML File
  Microsoft PowerPoint XML File
  Zipped File
  Unknown File Type

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